Low-Dose Dabigatran for Venous Sinus Thromboembolism Associated with Hereditary Dysfibrinogenemia: A Case Report.

Abstract

Dabigatran, an anticoagulant, may increase the risk of bleeding in patients with dysfibrinogenemia because of coagulation irregularities, especially at high doses. Cranial Magnetic Resonance Imaging (MRI) and Magnetic Resonance Venography (MRV) were used in the diagnosis of venous sinus thromboembolism in a 42-year-old woman with hereditary dysfibrinogenemia, as documented in our case report. Cranial MRI suggested thrombosis in the venous sinuses, which was confirmed by MRV as thromboses in the superior sagittal, straight, left transverse, and sigmoid sinuses. Instead of the usual fixed-dose, we gave the patient dabigatran based on how the coagulation indicators changed. Forty-six days after treatment, the patient's clinical symptoms had largely resolved. Follow-up cranial MR showed that most of the venous sinus thromboses had disappeared, with some mural thrombi still present in the superior sagittal sinus and left sigmoid sinus. In this report, we optimized the dabigatran regimen adjusted to thrombin time, ensuring efficacy with low bleeding risk.